Common Myths About Skin Cancer

The beloved sun causes skin cancer. Here are the facts about what that means.

November 11, 2014

The beloved sun causes skin cancer. Here are the facts about what that means.


Original article: http://health.usnews.com/health-news/patient-advice/articles/2014/11/06/common-myths-about-skin-cancer-debunked
By Kristine Crane | Nov. 6, 2014 | 9:00 a.m. EST

Shannon Doan-Duff was a classic skin cancer candidate. Red hair, blue eyes, skin so pale she compares it to raw chicken, and lots of freckles.

Doan-Duff, who lives in Harlan County, Kentucky, had gotten burned as a child a couple times visiting her grandparents in Hawaii, and she used tanning beds every week during law school and leading up to her wedding. Her grandfather died of melanoma, and her uncle suffered from it. But it never occurred to Doan-Duff that she, too, was at high risk for the disease, and until she was 42 years old, she’d never had a skin examination.

So when the odd-looking spot just above Doan-Duff’s collarbone appeared, she dismissed it. “I made every excuse in the world,” like just another freckle or an age spot, she says.

But when Doan-Duff’s colleagues were alarmed by the spot one Friday afternoon last January, she decided to get it checked out. One of those colleagues had herself suffered two bouts of skin cancer – basal cell and squamous cell carcinomas, the less deadly forms of the disease. The following week, Doan-Duff was diagnosed with the other one: that old family foe, melanoma. “I know five people who have melanoma, and only two are alive,” she says. “I’m sitting there thinking, ‘Will I live to see my daughter’s 19th birthday in May?’”

Fortunately, Doan-Duff’s cancer was early stage and treatable with the standard excision. She uses sunscreen religiously and gets a whole-body skin examination every three months, which she will have to do the rest of her life. “It’s a small price to pay,” she says.

Like many people, Doan-Duff believed a lot of myths about skin cancer until she was diagnosed with it. Here are some common misbeliefs, debunked:

“It’s just skin cancer.”

This was the common reaction Doan-Duff got when she told people – her husband included – that she had skin cancer. “No one would ever say that about breast cancer,” she adds. With skin cancer, there’s this idea that you can scrape, burn or cut it off, and you’re fine, says Vernon Sondak, chair of the department of cutaneous oncology at the Moffitt Cancer Center in Tampa, Florida. “Many times that’s true, but not all the time, and not for all types of skin cancer.”

That misconception feeds into another myth that all skin cancers are the same. There are three distinct types. Basal cell carcinoma is the most common form, striking about 3 million people each year, says Amy Forman Taub, a dermatologist in Lincolnshire, Illinois, and spokeswoman for the Skin Cancer Foundation. She adds that it’s slow-growing and usually not fatal. The spots are often flesh-colored or reddish (sometimes with blood vessels inside) and shiny, and they need to be surgically removed. Squamous cell carcinoma is less common and typically strikes older adults, Taub says. The spot looks like a wart or a scab, and it’s treated with surgery and radiation. Melanoma is the most deadly form of skin cancer, and it’s also the only cancer that is on the rise, especially among 20-somethings. “We don’t totally understand why,” Taub says.

“I’m not at risk of skin cancer.”

Did you leave your house to go to work today or run errands without putting on sunscreen? Then you’re at some risk of skin cancer. Certainly, not everyone runs the same risk of developing the disease, and Sondak is hopeful that a “risk-stratified screening approach” is on the horizon. A common myth is that people with darker skin, such as Hispanics and African-Americans, are at no risk of skin cancer because black melanin is more protective than red, but “there are a number of factors – genetic and biological – as well as visible,” Sondak says. He adds that patients with darker skin will often say, “‘I didn’t know I could get this.’ Bob Marley died of melanoma. Unfortunately, he’s not the only one.”

But people with fair skin need to be especially careful because they burn more easily, and even onebad sunburn can raise your risk of skin cancer. Brief but intense sun exposure can be harmful, Sondak adds.

“Where I used to live in Michigan, we would see people sitting outside during those late summer/early fall games with minimal or no sun protection, and they would leave the stadium beet red,” Sondak says. “Intermittent acute sun exposure like that is one of the best ways to get melanoma.”

And even in cloudier climes, people need to be cautious because ultraviolet light – the most dangerous kind thought to cause 90 percent of skin cancer – gets through the clouds. That means you still need to protect yourself during the winter – particularly athletes who spend a lot of time outdoors.

“I don’t have moles, so I’m not at risk of skin cancer.”

People with abundant moles are at higher risk of skin cancer, but that doesn’t mean everyone else is exempt. People need to watch for any changes in individual moles, or skin spots, Sondak says. “There’s no one signal that says this is always cancer. People have to be aware of any changes in skin, and a new or changing mole is very concerning for melanoma.”

For most people, making the call about what looks unusual is fairly instinctive. “I can remember thinking a few times [as I] looked in the mirror, ‘This just doesn’t look like anything else on my body,’” Doan-Duff says. But it was her doctor who noted the spot’s irregular borders and its various shades of brown and black.

The bottom line is if something has changed on your skin, get it checked out. And every adult should have at least one baseline whole-body mole check, Sondak says. “A doctor will have a better chance [at finding something] than a person will,” especially in hard-to-reach areas such as the back and scalp. The lower legs are also an area that often get missed – knees to feet – where skin cancers frequently appear, Taub adds.

“I don’t sunbathe. I use tanning beds, so my risk is lower.”

This is a glaring misconception. “In fact, tanning beds are concentrated ultraviolet lights. [You have] as much crammed into a few minutes as you would have gotten in a day,” Sondak says. “There is no such thing as a healthy tan.”

Taub adds, “One indoor tanning session can increase risk of melanoma by 20 percent.” In terms of cancer risk, that’s equivalent to smoking a pack of cigarettes a day for an entire year, she continues. “Basically indoor tanning is significantly worse than smoking cigarettes.”

So avoid the tanning booth, and when you’re outside for long periods, cover up as much as you can with clothing, hats and sunscreen. Make sure your sunscreen says “broad spectrum,” and lather it on, Taub says. The right amount is a shot glass (2 ounces) on your body, and a nickel-sized dollop on your face. Re-apply for every hour and a half that you are in the sun. “A typical bottle is 8 ounces. If you are out all day, you would use that whole bottle,” Taub says, adding that you should store your sunscreen in a backpack and dispose of it after a year.

Doan-Duff even recently started wearing clothing with built-in sunscreen, which she says makes her more comfortable resuming outdoor activities. “Our [wedding] anniversary is in March, and we celebrated by going on a hiking trip in the Smoky Mountains and a shopping spree for SPF clothing and hats at Eddie Bauer, Columbia and Under Armour, thanks to my husband,” she says.